Description of Arrangement:
Medicare measures the performance of Accountable Care Organizations (ACOs) on an annual basis referred to as a performance year. At the end of each performance year, Medicare will calculate the cost of care for those Medicare beneficiaries who receive their primary care through a CCQP ACO physician practice. This calculated cost will be compared to established spending targets. The goal of an ACO is to reduce unnecessary healthcare cost through proactive and preventive patient care. Medicare will also determine whether CCQP ACO has met the quality reporting and performance standards for that particular performance year.

If an ACO meets or exceeds Medicare’s performance standards for both the cost and quality measurements, it may be entitled to receive Shared Savings. Shared Savings is a portion of the dollars saved by instituting cost-reduction initiatives while demonstrating high quality patient care. The exact amount/percentage of Shared Savings that is awarded depends on how well the ACO meets or exceeds Medicare’s standards for performance.

If CCQP ACO receives Shared Savings for a particular performance year, it will distribute half of the Shared Savings to the physician practices that participated in the ACO that year. It will distribute the other half of the Shared Savings to those facilities who participated in the ACO that year. The portion of Shared Savings that is distributed to each party is determined by their specific performance on the quality measures and the number of Medicare beneficiaries for whom they provided primary care during the performance year.

Purpose of Arrangement:An ACO provides an opportunity for Medicare beneficiaries to receive high quality evidence-based health care that eliminates waste and reduces excessive costs through improved care delivery. The distribution of Shared Savings is designed to incent providers to incorporate quality improvement and the reduction of unnecessary cost into their practice.

Items, services, facilities or goods covered by the arrangement:Shared Savings Incentive Payments as outlined in Description

Date and manner of the Governing Body’s Authorization:Approved by the Board of Managers on 7/29/2015